7 Things No One Ever Tells You About Menopause

They're not all bad — what women need to know beyond hot flashes

Signs of menopause can begin 10 years before a woman is officially in this phase of her life, defined as a full year without a menstrual period. For most women in the U.S., this occurs around age 51 and signals a shift from the reproductive phase to the post-reproductive phase of life.

Hot flashes and night sweats are well known signs of menopause, but other lesser known issues can also crop up. Understanding why and what is happening can help make the transition easier. Here are seven things no one ever tells you (not all of them are bad):

1. Anxiety could increase. If you find yourself suddenly worried and anxious over seemingly nothing, hot flashes may be to blame. During a hot flash, the body releases a surge of a chemical called adrenaline, which makes arteries contract, says Dr. Philip Sarrel, emeritus professor of obstetrics and gynecology at Yale University School of Medicine. “This can make you feel anxious; it’s unnerving, although it’s not harmful,” he notes.

Heart rate increases by eight to 16 beats during a hot flash. The feeling should pass after the hot flash goes away, which is typically between 30 seconds and 10 minutes.

2. You may forget things. Remembering where you put your car keys or recalling the name of that '80s one-hit wonder may not be so easy after menopause. “Short term memory is directly affected by hot flashes,” says Sarrel. “If you give a woman a list of 10 words and ask her to remember them, she’ll be able to recite eight of them. If she’s having a hot flash, that drops to two.”

Memory and concentration issues may be related to stress more than hormonal fluctuations. Stay sharp by doing crossword puzzles, playing chess, reading or using a computer to challenge your brain.

3. Weight gain is not inevitable. Although putting on pounds is common after menopause, no clear evidence links menopausal weight gain to hormonal changes, according to a study in the American Journal of Epidemiology. Being less physically active and a slowdown in metabolism are believed to be the culprits. A resistance training program that preserves and maintains muscle, along with a cardio program, can help keep weight off as you age.

4. Vitamin E can help ease hot flashes. Hot flashes affect 87 percent of menopausal women and can occur up to 10 times or more a day, says Dr. Yen Tran of St. Joseph’s Hospital in Orange, Calif. “Women typically feel extreme heat in the upper body, especially the face, neck and chest and the flashes usually last between one to five minutes,” she notes. For women looking for a natural solution, vitamin E has been shown to help, Tran says. “Studies show taking 800 IU of vitamin E a day reduces hot flashes by one a day,” she adds.

5. You may become depressed. Changes in brain chemistry that accompany menopause can induce depression, says Sarrel. “Some women can even become suicidal,” he notes. Mood swings from changes in hormones can trigger laughing one minute and crying the next, or feeling depressed.

Although research shows menopausal status does not directly trigger feelings of sadness, women who’ve experienced depression earlier in their lives may be more susceptible to a recurrence during menopause. Ask your doctor for help if you become depressed. Physicians specializing in menopause can be found on menopause.org.

6. You’re at a higher risk for Type 2 diabetes. Diabetes is the No. 4 killer of women ages 55 to 64, according to the North American Menopause Society (NAMS). Women with diabetes have a higher risk of heart disease, stroke, kidney disease and other serious conditions. Hormonal changes may contribute to the risk of diabetes, but age and being overweight make you more likely to develop Type 2 diabetes.

7. You can still enjoy sex. Although it’s different for every woman, the freedom from worrying about birth control can make sex even better, especially if you take steps to ease vaginal dryness that accompanies menopause. One of the actions of estrogen is to protect the vagina, says Sarrel. “Sadly, women often give up on sex after menopause [due to lack of desire and vaginal dryness], and it’s unnecessary,” he adds.

Lubricants such as Astroglide, K-Y Jelly and silicone can help. Coconut oil also works as a natural lubrication alternative. “Hormone therapy in the form of low-dose creams such as Estrace, Vagifem, Premarin or Estring (low-dose vaginal ring) can restore estrogen locally as well,” says Tran. These prescription creams help restore vaginal blood flow and improve the stretchiness and thickness of vaginal tissue and reverses the thinning and dryness, versus providing the temporary relief lubricants do.

Next Avenue contributor Linda Melone is a California-based freelance writer specializing in health, fitness and wellness for women over 50.